Adina Afshan
Introduction
In the detailed maps produced during the era of the British Raj, the lines drawn to separate cities were far more than simple municipal boundaries; in fact, they functioned as diagnoses of the social and physical landscape. To truly understand the urban experience in colonial cities such as Lahore or Bombay, one must recognize that these cities were not merely divided along geographical lines, but were also dissected according to the colonial mindset—a mindset that viewed the city in terms of health and disease. For instance, on one side of the dividing line was a carefully planned grid of broad avenues, spacious and airy bungalows, and abundant, well-tended vegetation; every aspect of this environment was designed to encourage wellness and to facilitate the free flow of air, which was believed to prevent illness. In contrast, as one crossed to the other side of the line, the scene changed dramatically; here, a dense wave of humanity spilled through narrow, crowded streets, a space which the colonial administration regarded as a perpetual reservoir of disease and filth. It is important to emphasize that this dividing line was not merely a metaphorical construct; rather, it took tangible form in the shape of railways, parks, or even barren strips of land. In this way, the boundary was physically etched into the very fabric of the city, serving as a daily reminder of the ruling class's authority to define, separate, and ultimately control the health and organization of colonial society.
The spatial division was driven by a sense of colonial fear and anxiety, rooted in the concept of “tropical hygiene.” As the British Empire consolidated its power in the late 19th century, the medical standpoint of the time shifted from viewing the Indian Subcontinent (modern-day Pakistan, India, Bangladesh, and Myanmar) as a boundless, untouched land of resources and wealth, to a “land of death and disease,” a hostile environment where the climate itself poses a huge threat to the European constitution. From a colonial lens, the indigenous population was not just “different” from the European people; they were biologically dangerous. Brown bodies and “Black Cities” were often described by British officers as “reservoirs of infection,” instilling fear that diseases like cholera and malaria would spill over from the dense Indian quarters into the ‘pristine’ European communities. Thus, urban planning ceased to be about civic organization and became a matter of “survival.” The segregated cities, with wide “civil lines” and isolated cantonments, were the architectural response to the medical panic, designed to separate the ruler from the ruled.
With that being said, to interpret this segregation of land and people as merely a protective health measure means to overlook the power dynamics at hand. In order to understand how bricks and mortar were used to create an architecture of apartheid, this paper utilizes a multi-disciplinary theoretical framework. It applies Peter Conrad’s theory of the “medicalization of society,” examining how colonial authorities redefined social and racial prejudices as objective medical problems. By framing the indigenous population as a biohazard, the British administration was able to deploy “structural violence,” a concept defined by Paul Farmer, where social structures (in this case, urban planning and infrastructure used to physically harm specific populations.) Finally, this paper utilizes Immanuel Wallerstein’s “World-Systems Theory” to analyze the economic mechanics of this segregation, arguing that the “sanitary” European quarters functioned as a parasitic core, feeding off the health and resources from the indigenous periphery.
This research argues that in British India, urban planning was weaponized and used as a medical technology of control. By enforcing a cordon sanitaire and a tool to divert resources (health and wealth) from indigenous to settler groups, the colonial administration institutionalized structural violence. This segregation did not merely respond to disease; it manufactured the “unsanitary” conditions associated with brown bodies and cities, thereby validating a racial hierarchy through the guise of medical superiority. The “sanitary” city was a fabricated reality, funded by the systemic theft of resources from the very population it demonized.
This paper is broken into four parts. Section 2 establishes the historical and medical context, tracing the shift from the “Miasma” theory of disease to racialized germ theory that stigmatized the native body. Section 3 conducts a spatial analysis of the cordon sanitaire and cantonment system, using case studies from Delhi and Lahore to illustrate how the built environment enforced an apartheid on sanitation. Section 4 investigates the economic underpinnings of this segregation, utilizing tax data to reveal how resources were systemically siphoned from the “Native City” to subsidize the hygiene of the “Civil Lines.” Finally, the paper concludes by connecting these colonial “legacies” to modern globalization, exploring how the stigma of brown bodies in the Global South persists in contemporary urbanism and modern “exchange” and erasure of culture.
The Diagnosis: From Miasma to Germ Theory
To understand the spatial segregation of the colonial city, one must first understand the medical anxieties that it manufactured. In the early to mid-19th century, before the acceptance of modern germ theory, British urban planning in the Subcontinent was dominated by the theory of “miasma.” This term is defined by the Oxford Learner’s Dictionaries as “a mass of dirty, unpleasant-smelling air, often from rotting matter, which was once thought to cause disease, and figuratively, a pervasive, unhealthy atmosphere or influence.” It draws from the ancient Greek word for pollution; μίασμα, or “mianein.” Ancient physicians such as Hippocrates and Galen believed disease came from environmental factors, specifically “bad air,” later on called “miasma.” In the 14th century, a physician named Ibn Khatimah stated, “the direct cause of any disease is the corruption of the air surrounding the people or the air.” The core idea of this was that diseases were caused by “miasma”, which encouraged sanitation (large improvements in sewers, ventilation, and general infrastructure) and also emboldened the use of perfumed garments and air to ward off any “bad” vapor. Technically, certain practices based on the miasma theory (improvements on sewage systems) did reduce disease, mistakenly reinforcing the theory.
While the miasma theory was later replaced by the Germ Theory of disease, cultural beliefs about getting rid of odor made the “clean-up” a high priority for the British administration and urban planning. The medical doctrine held that disease was not caused by microscopic organisms, but by environmental factors; “bad air” from rotting vegetation, stagnant water, and the earth itself. Under this paradigm, the Indian environment was viewed as inherently dangerous and toxic to the European constitution, essentially, a “white man’s grave.” The very air could kill. As a result, early colonial architecture utilized high ventilation and elevation, which was also part of the native vernacular. The ‘Bungalow,’ which has become a popular modest home worldwide, is derived from the Hindi word “bangla,” meaning “of Bengal.” It is a low-roofed house with verandas built in the Bengal region during colonial rule. British colonials adopted the architectural style, and it spread globally, evolving into a popular, affordable, single-story home, as Anthony D. King, an architectural historian, notes in his analysis of the colonized bungalow, the structure was utilized as a “medical technology,” featuring high ceilings, clerestory windows, and large verandas intended to maximize airflow and dilute the “bad air” of the tropical climate. At this stage, the landscape was seen as the enemy, and the solution was one of the most climatic adaptations rather than strict racial separation.
However, the late 19th-century revolution in bacteriology, marked by the discoveries of Robert Koch and Louis Pasteur, fundamentally altered this dynamic. The identification of specific microbes as agents of disease shifted the medical lens from the environment (the air) to the body (the host). Theoretically, this scientific advancement of germ theory should have led to universal sanitation improvements. In the colonial context, however, it was weaponized. British medical officers began to view the indigenous population not just as victims of disease, but as “immune carriers,” biological vectors who had “adapted to the filth” of their environment. They posed a lethal threat to the “vulnerable” white body. The “native” was no longer just culturally different; they were scientifically categorized as a vessel for disease and infection. This pivot marked a critical moment in colonial governance: the shift from managing the climate to policing the population.
This shift from environmental determinism to biological essentialism exemplifies what sociologist Peter Conrad defines as the “medicalization of society.” In his theoretical framework, medicalization occurs when non-medical problems (often social, moral, or racial issues) are defined and treated as medical problems, usually in terms of illness, diseases, or disorders. By applying this lens to the colonial context, it becomes evident that the British administration “medicalized” their racial prejudices. The desire for separation was no longer framed as a political preference or racial dislike. It was reframed as a biological imperative. By labeling the indigenous population as “vessels” and “vectors,” the colonial state stripped away their humanity and reduced them to pathogen carriers. This medical terminology provided a scientific reason for the enforced segregation, allowing public administration to police strict social controls under the unassailable banner of “public health,” which was strictly reserved for the European population. Racism was disguised as innocent hygiene, making resistance to segregation equivalent to resistance against the science itself.
The “practical,” violent consequence of this medicalized racism was most visibly demonstrated during the Bubonic Plague epidemic of 1896 in Bombay. The British colonists renamed Bombay as “India’s Premier City” (Urbs Prima in Indis), making it their home and settlement. They erected large structures built in the Victorian Gothic style and huge roadways. The European upper class took over large parts of the city in villas and bungalows to enjoy the “clean air,” while leaving the “Black Town” (native quarters) extremely unsanitary. Because of its location as a port city, the Plague was brought in from ships carrying rats and fleas that actually transmitted the disease, versus the belief that the native population brought it. As historical Prashant Kidambi details in “The Making of an Indian Metropolis,” the colonial response to the outbreak was driven less by the epidemiological evidence and more by deep-seated (and self-inflicted) anxieties about the “filth” of the native lifestyle. Rather than focusing on the real vermin that transmitted the disease, British authorities fixated on the density and darkness of Indian dwellings, launching invasive “plague inspections” that traumatized the local population. Search parties, often composed of British soldiers, were empowered enough to force their way into private homes to hunt for concealed patients. This was not merely a medical intervention; it was an outrageous violation of social and religious boundaries. The entry of unknown men into the domestic sphere violated the norms of cultural female seclusion (also known as purdah in some Muslim and Hindu societies) and caste purity, sparking widespread panic and resistance. In the eyes of the administration, however, these cultural transgressions were justified by the “state of emergency,” further illustrating how medical authority was used to suspend civil rights of the subject population.
Furthermore, the fixation on the “dirty native” blinded colonial authorities to the actual epidemiological reality. While medical officers were busy stripping roofs, burning the clothing of the poor in public bonfires, and dousing mud homes in harsh disinfectants and chemicals, they largely ignored the actual vector of the plague: rat fleas. Because colonial gaze was so thoroughly fixated on the “filth” of the indigenous body and the density of “Black Towns,” they (perhaps intentionally) missed the biological evidence of the true carrier. As Kidambi argues, the “sanitary” measures were solely performative; designed to discipline the population rather than eradicate the pest and cause. By the time the administration made their realization public that the rats, not “native habits,” were driving the epidemic, the structural violence had already been inflicted. Thousands had been placed into “health camps,” their homes demolished or sterilized, proving that in the colonial imagination, the brown body was always the primary suspect.
Driven by the conviction that the “native quarter” was hopelessly unsanitary by design, the colonial solution was radical surgery rather than treatment. In 1898, the government established the Bombay Improvement Trust (BIT), which was an entity granted the authority to “cleanse” the city. However, the Trust’s primary method was not the provision of clean water or sewage infrastructure, but rather the aggressive demolition of the urban fabric. As Kidambi notes, the British engineers were obsessed with “ventilation,” the belief that driving wide, straight avenues through the dense “Black Towns” would allow sunlight and sea breezes to penetrate the “diseased” core, thereby killing the miasma (and later, the germs). This approach, often described as the “haussmannization” of Bombay, references the drastic renovation of Paris under Napoleon the Third, who prioritized visual order and airflow over human habitation. The trust targeted specific chawls (the working-class tenement buildings) that were multistory buildings with rows of small rooms and shared bathrooms on each floor. These were deemed “unfit for human habitation,” not to upgrade them, but to completely raze them, slicing the organic city into a “manageable,” survivable grid.
This “improvement” scheme exposed the deep hypocrisy of colonial urbanism: it sought to ensure overcrowding by reducing the housing supply. While the BIT enthusiastically demolished “unsanitary” dwellings, it failed to construct adequate housing for the thousands of displaced residents. The colonial “logic” was that the market would absorb the displaced, or that they would simply “return to their villages” (which were almost all destroyed). In reality, the evicted population had no choice but to squeeze into what remained of the already overcrowded neighborhoods, exacerbating the density and “filth” the British claimed to be fighting. The demolition of slums was a self-defeating prophecy; by destroying the homes of the poor without providing an alternative, the administration manufactured “new” slums, confirming their racialized belief that the “native” inevitably gravitated back towards “filth.” The “sanitary” city was thus built on a foundation of displacement, proving the health of the city was prioritized only as it served the colonial economy and the European “resident.”
The Quarantine: The Cordon Sanitaire
If the medicalization of race provided the moral justification for segregation, the physical architecture of the colonial city provided the means to enforce it. The transition from “managing the climate” to “policing the population” peaked in a specific urban design strategy: the cordon sanitaire. What was originally a term used to describe a physical barrier or landmark used to stop the spread of disease, in British India, it became a tool of urban planning. This spatial zone meant for quarantining an area manifested as a “safety buffer,” typically a stretch of open land, a railway line, or a park, that physically separated the European “Civil Lines” or Cantonments from the indigenous “Native City.” In cities like Delhi, Calcutta, Bombay, and Madras, a cordon sanitaire, or“sanitary belt,” was maintained between the British areas and the “Black Town.” The central motivation for implementing such large “sanitary” measures was the desire to protect the health of the British officials, soldiers, and their families, rather than the Indian population at large. The concept of what is modern-day “social distancing” might have stemmed from this urban design strategy of “spatial distancing.”
Separation between colonial rulers and the local population was no longer presented simply as a matter of political will or racial prejudice; it was recast as an unavoidable necessity dictated by biology. Historical geographer Stephen Legg frames this shift through the lens of biopolitics, the governance of life and health. Legg argues that in cities like Delhi, the colonial administration sought to create “disciplined environments” for the British, which required strict spatial insulation from the “unruly” and “disorderly” spaces of the indigenous population. This vividly illustrated the development of New Delhi, where political and health concerns became indistinguishable.
With the increasing influence of medical ideas, it was instead recast as an unavoidable necessity dictated by biology; there must be a separation between the brown and white body. We can see this being commanded in the case of Colonial Delhi, where the urban development illustrates how political and health concerns became deeply connected. A second type of “belt” or sanitaire was implemented, called the Glacis, a 500-yard strip of land meant to buffer the capital (New Delhi) and the rest of the city (Old Delhi). The British focus shifted to internal threats from nationalist groups organizing within local neighborhoods. Authorities responded with increased surveillance and the power to quarantine the city during unrest. The glacis, once a strategic move for military defence, had become repurposed to be used as a sanitaire, yet another health barrier between the Old and New Delhi. Although Old Delhi’s overcrowded neighborhoods needed more space and air, British officials maintained the glacis as a cordon sanitaire to protect the colonial elites from disease. Ultimately, it became clear that the segregation could not halt contagion between the two cities, leading to some limited slum clearance and a new approach to public health.
These architectural exclusions serve as a prime example of what medical anthropologist Paul Farmer defines as “structural violence.” Farmer argues that violence is not always physical or direct; it can be built into the structure of society, institutionalized in laws, policies, and, in this case, the built environment. In the colonial city, the cordon sanitaire was not a passive empty space; it was an active agent of violence. By physically distancing the European population from the “native vessels of disease,” the administration ensured that the indigenous population remained trapped in the very density and squalor the British claimed to detest. The architecture itself did the work of an apartheid, rendering the suffering of the colonized invisible to the colonizer, while ensuring the “white body” remained protected by the spatial buffer.
The physical separation of races was not merely a result of social preference or market forces; it was codified and enforced through rigorous legislation. The primary legal instrument for this spatial apartheid was the Cantonment Act of 1864, and its subsequent revisions in 1889 and 1924. Originally designed to protect the health of the British troops, these acts granted military authorities power to regulate urban space, sanitation, and movement within the Cantonments (military stations) and the adjacent Civil Lines. Under these acts, the colonial administration established strict zoning laws that mandated specific distances between European and Indian dwellings. The “safety radius,” often set at a minimum of 500 yards, was legally enforced to prevent the “aerial spread” of germs. This legal framework criminalized the presence of the brown body in European spaces. Indigenous populations were prohibited from residing within the Cantonment unless they were engaged in menial service for European households. Even then, they were subject to arbitrary eviction if their quarters were deemed unsanitary. This legislation emphasizes that the cordon sanitaire was not just a passive buffer zone; it was an active legal border. By transforming public health recommendations into penal code, the British administration ensured that “health” became the exclusive property of the white settlers, while the “native” was legally confined to zones of neglect.
To fully grasp the “structural” nature of this violence, one must zoom in further from the violence map to the scale of the individual housing unit: the Colonial bungalow. As Anthony D. King argues, the bungalow was not just a house; it was a “spatial apparatus” of control. Unlike the traditional haveli (a type of large house featuring a courtyard), which was introverted, dense, and shared by whole extended families, the colonial bungalow was extroverted, isolated, and singular. The defining feature of the bungalow was not the house itself, but the “compound,” the walled garden that surrounded it. This compound served as a private cordon sanitaire for the individual British family. It placed the white body at the center of a large, sanitized void, physically distancing them from the contamination of the street and the servants' quarters. The servants, the nokrani (cooks, sweepers, bearers), were relegated to the back of the compound in small huts, strictly separated from the main house. This micro-segregation mirrored the macro-segregation of the city. The architecture dictated that even within the same property, the “clean” master and the “dirty” servant must occupy different hygienic spheres. The bungalow, thus, naturalized the idea that space should be divided by race and class, training the colonial subject to accept their physical marginalization as a fact of life.
Nowhere was this architectural apartheid more deliberately executed than in the planning of Imperial Delhi (New Delhi) in the early 20th century. As Geographer Steph Legg details in “Spaces of Colonialism,” the construction of New Delhi was not merely an expansion of the existing city; it was a rejection of it. The British administration viewed the walled city of Shahjahanabad (Old Delhi) with both fascination and revulsion. To the colonial eye, the “Old City,” with its maze-like alleyways and mixed-use neighborhoods where shops and homes blended into one another, and high population density, was a “hygiene nightmare.” It represented everything the British feared: disorder, lack of ventilation, and the “miasma” of the native crowd.
In contrast, New Delhi, designed by Edwin Lutyens and Herbert Baker, was the physical, architectural embodiment of the “sanitary” ideal. Influenced by the Garden City movement, Lutyens designed a city of geometric precision, characterized by vast hexagonal grids, wide tree-lined avenues (like Kingsway, now Kartavya Path), and low-density housing. The most crucial feature, however, was not the design of the new city, but its separation from the old one. Legg notes that a deliberate cordon sanitaire, a buffer zone of open parkland and railway tracks, was maintained between the walls of Shahjahanabad and the northern edge of New Delhi. This empty space was not a neutral park; it was a barrier. It ensured that the “infected air” of the native city could not easily drift into the British-ruled one. The architecture created a binary existence: the “White Town” was spacious, green, and silent, while the “Black Town” was dense, dusty, and loud. This visual contrast reinforced the colonial narrative that the British were the natural custodians of order and sanitation, while the indigenous population was culturally destined for destitution.
Even these physical barriers could not put an end to the colonial anxiety of contagion. As William J. Glover, a researcher and scholar of South Asian and post-colonial urban history, argues in “Making Lahore Modern,” the segregation in cities like Lahore was driven by a constant, irrational “fear” that the boundary might fail. Glover describes a sanitary anxiety” where British officials worried that the 'dust,' 'smell,' and 'noise' of the native city would inevitably breach the cordon sanitaire. This fear reveals the psychological depth of the medicalization process: because the native was viewed as a biological hazard, no amount of physical distance felt truly “safe.” This anxiety led to the strict policing of the boundary itself. In Lahore, as in Delhi, the points of entry between the “Civil Station” and the “Native City” were heavily surveilled. The flow of people was asymmetric: indigenous servants, sweepers, and clerks were permitted to cross into the Civil Lines during the day to labor, but they were expected to retreat to the native quarters at night. This daily migration, the “clean” white city absorbing the labor of the “dirty” brown body by day and expelling it at night, exposes the hypocrisy at the heart of the system. The British wanted the labor of the Indian subject, but refused to live with the reality of their existence. The architecture of the city was thus designed to facilitate economic extraction while maintaining biological isolation.
The Urban Surgery: Pathologization of Native Life
If segregation was the defensive strategy of the colonial state—an effort to physically separate the “healthy” colonial populations from those deemed “sick” or dangerous—then the creation of Improvement Trusts signaled a new, more aggressive and interventionist approach. In the early 20th century, colonial authorities began to recognize the limitations of simply walling off and quarantining problem areas. The establishment of organizations such as the Lahore Improvement Trust (LIT) in 1936 marked a pivotal shift in policy. It became increasingly clear to the administration that cordon sanitaire and physical barriers could not adequately contain what they now defined as the “reservoir of disease” within the native city. As a result, the colonial medical and administrative gaze turned inward, adopting a far more proactive—and often invasive—stance toward the urban environments inhabited by the indigenous population. The dense, lively quarters of the old city, once seen as merely problematic, were now pathologized as malignant or cancerous growths on the urban body, demanding radical ‘surgical intervention.’ This new phase of urban governance represented a seismic transformation: containment was no longer sufficient; the city itself was to be reshaped, restructured, and sanitized according to the ideals and anxieties of colonial modernity.
William J. Glover, in his work “Making Lahore Modern,” describes this moment as a fundamental reimagining of the colonial project. The objective was not only to maintain a divide between the British and Indian populations, but to fundamentally reengineer the very environment in which Indian life unfolded. The Improvement Trust’s mission was framed as a technical and ostensibly apolitical endeavor, but it was in fact deeply ideological. As Glover articulates, the Trust aimed “to transform the physical environment of the city in order to transform the habits and character of its inhabitants.” Urban planning thus became an instrument of social engineering, tightly entwined with colonial notions of order, progress, and control. Through slum clearance, road widening, and the imposition of new building codes, the authorities sought not just to manage disease, but to reshape society itself—demonstrating the extent to which public health, urban space, and colonial power were inextricably linked.
The guiding philosophy of this era was that the physical structure of the indigenous city, its winding alleyways (also known as gulleys), internal courtyards, and high density, was inherently pathological. Colonial sanitary commissioners remained obsessed with the Victorian miasmatic theory of disease long after germ theory gained traction everywhere else. They held onto the belief that “bad air” trapped in narrow spaces was the primary vector of illness. This belief system was pathologized into the very geometry of the Walled City. The solution was formally termed “urban surgery,” driving wide, straight boulevards through the heart of historic neighborhoods to “let clean air in.” Glover highlights how this approach prioritized abstract medical theories over actual human needs. He observed that to the colonial urban planner, the native city appeared as a mass that needed to be ordered by the “rational” grid. The narrow street was not seen as a shaded, cool communal space adapted to the hot climate, but as a blockage to the city’s circulatory system. Far from being haphazard or unsanitary, the design of these gulleys reflected a sophisticated understanding of climate adaptation. Narrow lanes were purposefully laid out to channel cooler breezes through the city, while their orientation, often north-south oriented, was chosen to reduce the exposure of the street to the harsh midday sun. The close proximity of buildings created deep shade, significantly lowering ground temperatures and protecting residents from the intense heat. This system of mutual shading and reduced sky exposure meant that direct solar radiation was kept at a minimum, making the streets more comfortable and habitable. Traditional homes further enhanced this microclimate with internal courtyards, which acted as thermal regulators. As hot air rose and escaped from these open courtyards (a process known as the stack effect), it drew in cooler air from the shaded gulleys and small openings, setting up a continuous flow of ventilation that refreshed both the homes and the surrounding lanes. These architectural adaptations displayed a nuanced response to environmental conditions and urban density. These moves went unrecognized by the British colonial administration, which misinterpreted these dense, vibrant neighborhoods as merely chaotic and unsanitary, overlooking the environmental logic embedded in their design.
The language used in official reports became increasingly clinical. The city was described in terms of “congested areas,” “blighted spots,” and “sanitary voids.” This terminology served a specific purpose; it stripped neighborhoods of their social and human context, reducing them to medical problems to be solved. Glover points out that even when planners like Patrick Geddes advocated for “conservative surgery” (a gentler approach of pruning rather than slicing), the overarching colonial machinery preferred radical erasure. The logic was absolute: “The only way to improve the Old City,” Glover summarizes the prevailing mindset, “was to thin it out.”
The medical critique extended from the public street into the most private recessions of the home. The traditional courtyard haveli, designed for privacy and climate control, was reinterpreted by sanitary commissioners as a “breeding ground” for tuberculosis and cholera. The very architecture of native life was deemed a health code violation. British officials viewed the introverted nature of the haveli, with its lack of outward-facing windows, as secretive, deceptive, and unsanitary. Glover argues that this was a conflict between two ways of being, or ontologies. For the native resident, the home was a sanctuary; for a medical officer, it was a Pandora’s box. Glover writes that the colonial critique of the indigenous dwelling was relentless: “The courtyard house... was condemned for its lack of ‘thorough ventilation’ and for its darkness.” The drive for improvement thus became a violation of domestic privacy. Sanitary inspectors demanded access to the most private quarters of the home, in the name of public health, breaking the sanctity of the women’s quarters. The “medical” need to inspect for mosquito larvae or ventilation shafts became a tool of surveillance, effectively declaring that the native right to privacy was secondary to the colonial right to hygiene. Crucially, this restructuring was not just biological, but moral. The colonial administration operated under the principles of “environmental determinism,” the belief that a disorderly environment produced disorderly people. As Glover argues, the British conflated “dirt” with “vice” and “density” with “deviance.”
By straightening the streets and opening up the native quarters to the “light of day,” the British believed they were also sanitizing the morals of the population. A straight road allowed for “better” airflow, but it also allowed for better surveillance, police control, and movement of troops. Glover captures this dual purpose, noting that the reshaping of Lahore was intended to produce “a new kind of citizen, one who was disciplined, orderly, and hygienic.” The tragedy of this new approach was the destruction of social cohesion. The “improvements” often tore apart the intricate social networks embedded in the mohallas (neighborhoods). In the name of public health, the organic unity of the city was fractured, replacing a communal, group-centered way of life with a grid imposed by a foreign, clinical “rationality.” The native city was no longer treated as a home for its inhabitants, but as a patient on an operating table, subject to the logic of a scalpel.
There is no clearer example of this “urban surgery” than the reconstruction of the Shahalmi Gate neighborhood, following the devastation of 1947. In June of that year, amidst the communal violence of Partition, the Shahalmi Gate area, a prosperous Hindu commercial stronghold, was set ablaze. The fire raged for days, gutting the dense medieval fabric of the neighborhood and leaving behind little more than smoldering ruins. For the residents, this catastrophe marked the loss not only of homes and businesses but also of a deeply rooted community, traditions, and a way of life that had evolved over centuries. The trauma of forced displacement and the erasure of cultural memory would reverberate for generations. Yet, for the Lahore Improvement Trust (LIT), the destruction wrought by the fire was seen in a starkly different light: as an unprecedented opportunity. The LIT had long faced obstacles in its urban renewal ambitions. Efforts to modernize the Walled City, particularly the desire to carve a wide, modern thoroughfare through the heart of Shahalmi, had been repeatedly thwarted by two major barriers: the prohibitive cost of acquiring densely packed properties and the persistent resistance of residents who refused to sell or relocate. The devastation caused by the fire conveniently cleared these obstacles. With much of the area reduced to ashes and the original owners forcibly displaced by violence, the LIT could move forward unhindered with its plans for reconstruction.
In the aftermath, the neighborhood was transformed. Rather than rebuilding the Shahalmi Gate area in a way that respects its history or the needs of the displaced residents, the LIT implemented a new street layout, introducing a widening scheme that had been on the drawing board for years. The charred remains of the havelis were bulldozed, the winding gulleys were replaced with wide, straight dual-carriageways that still exist today as the Shah Alam Market. This fundamentally altered the character of Shahalmi. While these changes were justified in the language of progress and public health, they also served as a textbook example of how disaster and violence could be leveraged by authorities to advance an agenda of spatial and social engineering, an agenda that often prioritized bureaucratic vision and colonial ideals of order over the lived realities and needs of the local population. Glover argues that this was a moment where “medical” logic of the state revealed its violence. The destruction of the city was not mourned; it was capitalized. The new Shah Alam Market was celebrated as a triumph of modern planning; a sanitary, ventilated, and accessible to vehicular traffic, built literally on the ashes of the indigenous city. This event crystallized the colonial attitude that the native city was only “improved” when it was erased. The “surgery” was “successful.” The patient had died, yet the surgeons were celebrating.
The most disturbing aspect of this colonial medicalization is that it did not end after Partition in 1947. The “urban surgery” model established by the British has metastasized into the globalization of the modern city. The colonial stigma attached to the “native city” (that it is dirty, chaotic, and diseased) has been seamlessly adopted by the post-colonial elite and the forces of global capital. Today, the “Improvement Trust” has been replaced by the Development Authorities (such as the LDA), but the logic remains almost identical. The modern drive for “World Class Cities” is simply the colonial “Civilizing Mission” repackaged and rebranded in the language of neoliberal economics.
Just as the British built Civil Lands to escape the miasma of the Walled City, the modern elite retreated into their gated communities (like the DHA zones or Bahria Town). These spaces are the modern realization of the colonial fantasy: sterile, grid-like, heavily guarded, and aggressive, separated from the “mess” of the general public. The “native” quarters are not the slum or katchi abadi. These areas are still viewed through a lens of medicalization, not as communities suffering from resource neglect, but as “sores” on the face of the city that must be cleared to make way for shopping plazas and signal-free corridors. The demolition of low-income housing for infrastructure projects is justified using the same rhetoric of “cleaning up” the city that the British used in the 1920s. The “anxiety of contagion” has gone global. In the era of global pandemics and international tourism, the dense, organic urbanism of the “Old City” is marketed as a museum piece for tourists, but is treated as a biohazard for residents. The modern state’s obsession with “encroachment removal” drives is a direct lineage of the colonial obsession with ventilation.
Thus, the medicalization of the city has created a permanent stigma. To be “modern” and “global” is to look at the West, vertical, concrete, and sterilized. To be “local,” “indigenous,” or “traditional” is to be viewed as a medical risk, a chaotic element that must be constantly policed and improved. Or surgically removed. The colonial doctor has left the building, but his diagnosis, that the native way of life is a disease to be cured, remains the governing principle of the urban reality.
Conclusion
The trajectory of the colonial city, from a site of trade to a “reservoir of disease, and finally to a patient undergoing “urban surgery,” reveals that the history of urbanization in the Global South is not merely a history of bricks and mortar, but a history of biology and fear. As explored in this paper, the medicalization of the city was never a neutral act of public health. It was a political technology, a way for the colonial state to rationalize its dominion by framing the indigenous population, not as subjects with rights but as pathogens with vectors. The journey traced, from the defensive cordon sanitaires of the 19th century to the aggressive demolitions of the Lahore Improvement Trust in the 20th century, highlights a singular, obsessive logic: the belief that the native city was a biological threat that had to be contained, sanitized, or erased. However, the most unsettling conclusion of this investigation is not what happened in the past, but what persists in the present. The British administration may have “departed” the subcontinent in 1947, yet the medicalized gaze remains the dominant way the cities and people of South Asia are viewed today.
Current conditions of these patients (the cities) exist with a “phantom limb;” the colonial “surgeon” is gone, yet the itch to segregate, to sanitize, and to surgically alter the city remains. This stark divide is prominent in the modern metropolis. The “Civil Lines” have mutated into the gated housing authority (DHA, Bahria Town), spaces that market themselves on the very same colonial virtues of “ventilation,” “order,” and “security.” Conversely, the “native city” has mutated into the “encroached zone,” the katchi abadi, or the chaotic downtown. The language of urban planning remains violently clinical: when discussing the “choking” traffic and “cancerous” slums, the only cure is believed to be the bulldozer, or the “scalpel.”
This medicalization, however, has evolved into a more insidious form regarding the people themselves. In this modern globalized economy, the “native” culture has become a trend, yet it is stripped of its origins. There is a paradoxical phenomenon where the products of the “native city,” its food, fashion, and its architectural aesthetics, are eagerly consumed by the “white elite,” while the producers of the culture are still viewed through the lens of hygiene and contagion. This is witnessed in the “gentrification of aesthetics.” The chai of the roadside chaiwala stall becomes a “Golden Milk Latte” in a “sanitized” cafe with baristas. The intricate design of havelis appears on high fashion runways; the chaos of the bazaar is mimicked in boutique shopping experiences. This disconnect is perhaps most visibly played out in the digital realm, where the medicalized view of the Global South clashes with the reality of its people. A recent viral trend sparked by the South African singer Tyla’s concert in Mumbai saw international users expressing genuine shock at the visibility of young, fashionable, and modern Indian men and women attending the event. Comments flooded different social media platforms broadcasting the event, like TikTok, Instagram, and Snapchat, with users admitting they ‘didn’t realize India could be so modern’ or that its people could fit such a global standard of beauty.
This collective gasp of surprise is really telling. It exposes the persistence of the colonial diagnosis: the global imagination still expects the ‘native’ to be backward, unhygienic, and aesthetically displeasing. The ‘modern’ South Asian is treated as an anomaly because the default mental image of the region remains rooted in the colonial anxiety of dust, poverty, and disease. The viral ‘shock’ proves that while the West is happy to consume the culture (the music, the food, the art), it still struggles to humanize the people without the filter of surprise. There is a want of an aesthetic of the ‘Other,’ but the people are still conditioned to view the ‘Other’ themselves as a problem to be solved, not a peer to be admired or respected. The modern consumer wants the “flavor” of the native without the “risk” of the native. It’s a form of cultural biopsy. The global gaze extracts the “safe,” colorful, and marketable elements of the culture, while continuing to pathologize the people who created them as “backward,” “loud,” or “unhygienic.” There is a love for the “ethnic chic” aesthetic, but a continuous construction of walls to keep out the “ethnic” reality. This reveals that the colonial anxiety of contagion has not disappeared; it has simply become more selective. The need for the culture to be “clean,” packaged, shrink-wrapped, and divorced from the organic reality of the streets it came from.
Ultimately, this essay argues that there must be a fundamental change in the metaphor for the city and its people. For too long, the indigenous conditions have been treated as a body to be “cured.” The logic of the “cure” is violent: it identifies a sickness (the poor, the dense, the organic) and seeks to eradicate it to restore a “healthy” norm defined by Western standards. If there is to be a way to move past this colonial hangover, there needs to be a transition from a curing mindset to a healing mindset. Curing imposes an external standard of health (the grid, the western suit, the gated community) onto a body that it does not fit. Healing listens to the body itself. It acknowledges the trauma of the past and seeks to integrate the city rather than partition it. A “healed” society would not be one where culture extraction for microtrends continues while shunning the people. It would be a society that recognizes the value in density, the social safety nets of the mohallas, and the validity of the indigenous life before it is packaged for sale. It would stop viewing its own citizens as bacteria to be managed in a petri dish and start viewing them as the lifeblood of the urban organism.
The medicalization of the city was a tragedy because it taught the world to fear our own neighbors as causes of contagion. De-medicalizing the worldview is the only way to finally reclaim the native identity, not as a sterilized trend, but as a living, breathing, and valid reality.
Annotated Bibliography
1. Arnold, David. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. 1993.
This text is essential for establishing historical precedents in the medical gaze in India. Arnold details how the British colonial administration used epidemic diseases, specifically plague, cholera, small pox, etc.. as a justification for intrusive state control. The book provides historical evidence for the cordon sanitaire, showing how the medical interventions were typically indistinguishable from military or police actions.
2. Chattopadhyay, Swati. “Blurring Boundaries: The Limits of ‘White Town’ in Colonial Calcutta.” Journal of the Society of Architectural Historians, vol. 59, no. 2, 2000, pp. 154–179, https://doi.org/10.2307/991588.
3. Conrad, Peter. The Medicalization of Society on the Transformation of Human Conditions into Treatable Disorders. John Hopkins University Press, 2007.
Provides foundational sociology for essay's argument. Conrad defines "medicalization" as the process by which non-medical problems (social, behavioral or in this case, racial) are defined and treated as medical problems. This framework is applied in the Introduction, and Part 2, to explain how the British administration turned "race" into a "public health" issue, thereby justifying political control under the guise of medical necessity.
4. Farmer, Paul, et al. Pathologies of Power: Health, Human Rights, and the New War on the Poor. Tantor Media, 2017.
The concept of "structural violence" is core to the theoretical mechanism used in the paper, explaining how the architecture of an environment can be used to physically (and mentally) harm people. A view beyond the idea of segregation just simply being a separation, instead shifts view to being an act of violence that denies resources and dignity to the people already existing in a place. In this case, the British Raj.
5. Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. Routledge, 2017.
Provides overarching theoretical framework for essay; the medical gaze. Text is used to define how the act of "seeing" is an act of power. Applies Foucault's concept that the patient is reduced to a non-person (a set of symptoms) to the city itself, theoretical critique of how power operates through perception and observation
6. Glover, William J. Making Lahore Modern: Constructing and Imagining a Colonial City. Oxford University Press, 2011.
Primary case study source for essay. Glober's history of LIT (Lahore Improvement trust) and reconstruction of Shahalmi Gate provides specific evidence for Urban Surgery. Essay relies on Glover's argument that colonial planning was driven by a "sanitary anxiety," irrational fear that the disorder of the native city would infect the civil station.
7. Hooks, Bell, and Adenrele Ojo. Black Looks: Race and Representation. Findaway World : Tantor Audio, 2022.
Used in conclusion, this text provides a framework for the "Sanitized Souvenier." Hook's work "Eating the Other" argues that dominant cultures often consume the "spice" or "flavor" of the 'Other' while rejecting the people themselves. Citation supports the essay's final pivot to modern globalization and commodification of native aesthetics.
8. Kannadan, Ajesh. “History of the Miasma Theory of Disease.” ESSAI | College Publications | College of DuPage, dc.cod.edu/essai/?utm_source=dc.cod.edu%2Fessai%2Fvol16%2Fiss1%2F18&utm_medium=PDF&utm_campaign=PDFCoverPages. Accessed 2018.
The article provides historical background on pre-germ theory medical beliefs. It is used in the opening sections to explain why the British initially focused on the "bad air" and ventilation the (Bungalow) before shifting their focus to the racialized body.
9. Kidambi, Prashant. The Making of an Indian Metropolis: Colonial Governance and Public Culture in Bombay, 1890-1920. Ashgate, 2007.
Crucial for the section on the Bombay Plague. Provides historical data regarding the "plague inspections" and the formation of the BIT (Bombay Improvement Trust). It supports the argument that the colonial administration prioritized the demolition of "native" housing over the provision of actual healthcare.
10. Legg, Stephen. Spaces of Colonialism: Delhi’s Urban Governmentalities. Wiley, 2011.
Source offers a comparative perspective to Glover's work on Lahore. legg analyzes New Delhi to show that "Improvement Trusts" and the "Cordon Sanitaire" were standardized tools of British governance across India. This text universalizes the argument, suggesting that the 'medicalization' of the city was part of a broader "governmentality." Also utilizes Foucault's ideas to analyze how British colonial rule in Delhi structured spaces, policing and population control.
11. Pathak, Sushmita. “How Bubonic Plague Reshaped the Streets of Mumbai.” NPR, NPR, 7 Mar. 2021, www.npr.org/sections/goatsandsoda/2021/03/07/968856331/how-bubonic-plague-reshaped-the-streets-of-mumbai.
The article provides a modern retrospective on the Bombay Improvement trust, linking the 1896 plague directly to physical changes in the streetscape (widening roads, ventilation, etc..). Serves as a bridge in the essay between historical "urban surgery" and modern understandings of how pandemics reshape cities.
12. Wallerstein, Immanuel Maurice. The Modern World-System. Academic Press, University of California Press, 1974.
Wallerstein's World Systems Theory is utilized to analyze the economic mechanics of segregation discussed in the essay. Argues that the "Civil Lines" functioned as a parasitic "core" extracting resources (taxes and labor) from the "periphery" (the native city). Source supports the argument that the "sanitary" city was not self-sustaining, but relied on the systemic theft of resources from the very population it stigmatized.
